Summary Prevalence rates ofleprosy have reduced considerably in many states where multidrug therapy is in operation. However, reduction in prevalence alone is not sufficient as the social consequences of the diseases on the life of the patient are often severe and persist even after its cure. The present paper, therefore, investigates social impact with special reference to gender differentials. Data obtained from structured questionnaires (n = 606) is analysed for this purpose. It was observed that the initial delay in identifying the skin changes as the symptoms of the disease were higher for females (29 months) than males (24 months). Even after identifying the symptoms, women were observed to depend exclusively on nonmedical treatment for a longer period (10 months) than males (6 months). Upon starting the medical treatment fe males were observed to be more compliant than males, but the benefits of regularity appeared to be outweighed by the initial delay in starting medical treatment. The social impact on daily life was more severe for females than males as revealed by the isolation from daily activities, such as, restrictions on participation in fa milial functions, restrictions on touching children. The paper highlights implications of gender bias on detection and treatment, and suggests modifications for control programmes.The leprosy control programme in India aims to bring down the prevalence of leprosy to below 1/10,000. This is in accordance with the WHO declaration of the global elimination of leprosy by the year 2000 AD. 1 With the introduction of multidrug therapy (MDT), profound changes in the epidemiology of the disease have occurred, 12 with a significant reduction in the prevalence rates in many states, where MDT is in operation. 2 However, reduction in prevalence alone is not sufficient as the social consequences of the diseases on the life of the patient are often severe and persist even after its cure. The social aspects associated with this disease are therefore as important, if not more important than the biological ones. 190

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Aim: To study the efficacy of uptitrating the dose of Teneligliptin from 20 to 40 mg in patients with type II diabetes mellitus. Method: A retrospective, comparative analysis was undertaken in 853 type II diabetes mellitus patients (499 males and 354 females) who had follow-up records for more than 6 months. These patients were uncontrolled after use of atleast three oral antidiabetic drugs (OADs) and Teneligliptin 20 mg was added as the fourth drug. Patients who remained uncontrolled with the addition of 20 mg of Teneligliptin at the end of 3 months and were switched to receive 40 mg of Teneligliptin daily were included in this study. Results were analyzed at 3 and 6 months to ascertain efficacy of high-dose (40 mg) Teneligliptin. All other OADs remained the same in both groups. In all patients, the fasting blood glucose, postprandial blood glucose, and hemoglobin A1c (HbA1C) were evaluated and compared. Result: A total of 853 patients whose dose of Teneligliptin was increased from 20 to 40 mg were included in the study. At the end of 3 months after using Teneligliptin 40 mg, mean reduction in HbA1C was 0.5% (p-value 0.154). Similarly, mean reduction in fasting blood sugar (FBS) and postprandial blood sugar (PPBS) was 6.5 and 3.6 mg/dL, respectively (p-value 0.234 and 0.143). At the end of 6 months after using Teneligliptin 40 mg HbA1C showed no change but mean FBS and PPBS showed a modest reduction of 14.6 and 14 mg/dL, respectively (p-value < 0.001). Conclusion: The results of our study show that there was no statistically significant improvement in glycemic parameters when dose of Teneligliptin was increased from 20 to 40 mg at 3 months. But at 6 months, the FBS and PPBS showed a modest reduction of 14.6 and 14 mg/dL, respectively (p-value < 0.001) but the HbA1C showed no change.

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